Medical Insurance
Prudential Life Assurance offers insurance products that can be tailor made. We also offer managed fund care administration schemes.
Insurance Schemes
Medical insurance covers international evacuation, repatriation and overseas travel insurance. Our products offer specified benefits for each member that cover the medical expenses of members incurred within Zambia.
Benefits
Each of the cover levels has two (2) major benefits which are OUT-PATIENT and IN-PATIENT. Additional benefits are Optical and Dental. Maternity benefits (normal pregnancy and delivery) and pregnancy complications are covered under the overall limit.
Managed Care Administration Schemes (MCAS)
Prudential Life Assurance offers expert advice in the MCAS design process. This ensures that we meet all our client’s specific insurance needs. We also offer tailor made advice on methodology and access to the benefits to ensure the client’s health care needs are met.
Product Cover
These benefits under this scheme may be specified or unspecified and with or without standard benefit exclusions.
| Consultation |
Laboratory |
Diagnostics |
| Prescription Medicines |
Dental |
Optical |
| Maternity Care |
Hospitalization |
Theatre Costs |
| Emergency Rooms |
Doctors’ Fees |
Surgeons’ Fees |
| Disease Management |
X-Rays |
Nursing Care |
General Terms
Membership Enrollment
Prudential issues membership cards to each principal member on the scheme. The membership cards enable the member to access medical services at any of our registered Health Care Providers throughout the country.
Additions and Deletions
During the policy year, the client must advise us of any changes in membership i.e. addition or removal of members from the scheme; and the records shall be amended accordingly.
Reports
Management reports are provided on a monthly, quarterly and yearly basis. These reports include;
- Member utilisation reports
- Scheme utilisation reports
- Overall performance of the scheme
- Any other reports requested by the Client.
Confidentiality Of Medical Records:
We value the confidentiality of medical records and we therefore always ensure the following:
- Medical information obtained from the Provider is used only for the purposes of processing the claim.
- Reports submitted to our clients do not contain medical information except for name of patients, invoice number, date of treatment and nature of treatment (out-patient or in-patient).
- Medical records are kept in secure premises and only accessed by authorised officials.
